Thursday, November 3, 2011

By James Gallagher Health reporter, BBC News Does an aspirin a day keep the cancer surgeon away? A daily dose of aspirin should be given to people at high risk of bowel cancer, say scientists.

Two pills a day for two years reduced the incidence of bowel cancer by 63% in a group of 861 at-risk patients, a study reported in The Lancet said.

Newcastle University's Prof Sir John Burn, who led the study, said the evidence "seems overwhelmingly strong".

Other experts said the findings added to a growing body of proof that aspirin could be used in the fight with cancer.

The study was conducted on 861 patients with Lynch syndrome, which affects one in every 1,000 people.

They struggle to detect and repair damaged DNA which means they are more likely to develop a range of cancers including those of the bowel, womb and stomach.

'Good deal'

When looking at all patients in the trial, those in the group given 600 milligrams of aspirin every day developed 19 tumours compared to 34 tumours in the other "control" group, a reduction of 44%.

When the researchers looked at just those patients who took the medication for at least two years the reduction was 63%.

There was also an effect on other cancers linked to Lynch syndrome, which fell by half in the treatment group.

Prof Sir John Burn, from Newcastle University, said there were 30,000 adults in the UK with Lynch syndrome.

If all were given the treatment he said it would prevent 10,000 cancers over 30 years and he speculated that this could possibly prevent 1,000 deaths from the disease.

However, there would also be side effects.

"If we can prevent 10,000 cancers in return for 1,000 ulcers and 100 strokes, in most people's minds that's a good deal," he said.

"People who've got a clear family history of, particularly, bowel cancer should seriously consider adding low dose aspirin to their routine and particularly those people who've got a genetic predisposition."

Aspirin is already well known to reduce the risk of heart attack and stroke in high risk patients.

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Audrey Francis describes herself as "a bit of a walking time bomb".

There is a history of cancer in her family and she has been diagnosed with Lynch syndrome.

Seventeen years ago she had a hysterectomy. That was when doctors discovered she had not one but two cancers - in the womb and the ovaries.

Tests showed she had a chunk of DNA missing which was causing the cancers: "I actually had the inability to stop the cancers developing," she said.

She took part in the trial and has since decided to self medicate with aspirin: "I've got my fingers crossed and I'm hoping it'll do the trick for me."

Other studies over the past two decades have suggested the pain killer reduced cancer risk, but this was the first randomised control trial, specifically for aspirin in cancer, to prove it.

In 2010, a study suggested patients given aspirin had a 25% lower risk of death during that trial.

Prof Peter Rothwell, from Oxford University, who conducted that study said the latest research "certainly helps to build a consistent picture, all pointing in the same direction that there is a link with cancer".

Cancer Research UK's Prof Chris Paraskeva said: "This adds to the growing body of evidence showing the importance of aspirin, and aspirin-like drugs, in the fight against cancer."

'Balanced argument'

One of the questions asked by the research into aspirin was whether healthy people with no family risks should take the drug.

The lower the risk of heart attack or cancer, the lower the benefit of taking aspirin, yet there are still potentially deadly side effects.

Sir John said that it was a "finely balanced argument" and that he decided the risks were worth it for him.

"I think where we're headed for is people that are in their 50s and 60s would look very seriously at adding a low dose aspirin to their daily routine because it's giving protection against cancer, heart attack and stroke.

"But if they do that they've got to have their eyes wide open. They will increase their risk of ulcers and gastrointestinal bleeds and very rarely they will have a stroke caused by the aspirin."

We can all think of times when we have gobbled down food without even really tasting it.

But could that kind of high speed eating contribute to weight gain?

This is the question being posed by researchers working in Europe's most advanced 'flab lab', a unit that does hi-tech research into obesity.

Its official name is a whole body calorimeter and scientists at the University Hospital Coventry and the University of Warwick are hoping it will help them have a better understanding of how food, exercise, medicines and sleep affect our weight.

One of their first experiments is into the speed of eating, the way it changes appetite, and the rate at which energy is burned up.

Helga Perry is one of about a dozen patients taking part. She will spend three separate days in the lab, which is an air-locked chamber that makes very precise calculations of how much energy she burns.

Fast food

On day one of the experiment, she will eat lunch in 10 minutes, on the second day she will be told to take 20 minutes, and on a third, she will have a 40-minute meal. The researchers control this by dividing her sandwich and yoghurt into small portions and giving them to her at five-minute intervals.

At the end of the day her appetite levels are tested when she is offered an all-you-can-eat selection of food.

Helga Perry has her lunch delivered to the lab in small portions

Provisional research from Japan suggests that eating more slowly may help suppress the appetite and lower the risk of developing diabetes.

The researchers at University Hospital Coventry say they want to see whether they reach the same conclusion in this more carefully controlled trial.

Lead researcher Dr Tom Barber says the experiment could add to scientific knowledge about obesity: "If you prolong your meal this could, over time, actually promote weight loss."

Obesity epidemic

Almost one in four of all adults in the UK are currently obese and by 2050 that is expected to rise to one in two.

Helga Perry says she is taking part in the trial because she thinks it is important to help increase the understanding of obesity.

"If it does something to help people who've struggled to lose weight, like me, then it can only be a good thing," she said.

Prof Sudhesh Kumar. who runs the unit, also hopes to investigate links between obesity and diabetes.

Prof Sudhesh Kumar runs the flab lab - the Human Metabolic Research Unit. He said: "The research potential of this new unit is vast, we are looking forward to being able to make a difference to patients around the world."

At the end of her second day of taking part in the trial, Helga Perry emerges from the sealed unit with a sigh of relief and takes a deep breath of fresh air.

She spent her day reading and browsing the web, so she hasn't been bored, but she did find it confining. "It was like being in a submarine," she observes.

She says she found it interesting to be forced to eat so slowly: "I usually gobble my food down, it felt as if I tasted my lunch properly."

She ate a small portion of food at the end of the day, but did not feel very hungry.

The researchers do not expect results for a few months, but ultimately they hope to offer some answers to the many questions about the causes of the world's obesity epidemic.

By Adam Brimelow Health Correspondent, BBC News Big projected rise in new cancer cases The number of new cancer cases in the UK could rise by 45% by 2030 to more than 430,000 a year, research suggests.

The rise is explained almost entirely by the expected increase in the number of people living in the UK and the ageing population.

Cancer Research UK, which funded the study published in the British Journal of Cancer, says the NHS must act now to avoid being "overwhelmed".

The Department of Health said it was already responding to the challenge.

The research presents projections for 23 different types of cancer. The results are based on taking figures from cancer registries going back to 1975, and then projected forwards to 2030, taking into account expected changes in population.

The study suggests that the number of new cases could rise from about 298,000 in 2007 to 432,000 by 2030 - an increase of 45%. The increase in men is forecast to be 55%, and 35% in women.

Drawing on data from the Office for National Statistics, the authors assume a rise in the population from 61m in 2007 to nearly 71m by 2030.

The proportion of elderly people is projected to grow at a faster rate. The figure for over 65s stood at 16% in 2007. By 2030 it is expected to reach 22%.

The impact of ageing is starkly reflected in the projected increase in the figures for prostate cancer, which is especially common in older men.

Cases are projected to increase from about 36,000 in 2007 to more than 61,000 by 2030. The authors say even this is probably an under-estimate because in future more men are likely to be tested for the disease.

Although the overall number of cancer cases appears set to rise, the authors conclude that after adjusting for the growing and ageing population, cancer rates are likely to remain "broadly stable". But there are variations within this.

The rate of breast cancer is projected to fall by 7%. The authors attribute this to a recent reduction in the use of hormone replacement therapy, which is a risk factor for the disease.

However the rates of malignant melanoma and kidney cancer are forecast to rise sharply in men and women.

One of the authors, Prof Peter Sasieni acknowledged that the figures should be treated with caution, but said they provided a framework.

"Projections of cancer cases are important for planning health services so we can understand where the future burden is on the NHS and also where health awareness messages need to be raised."

Cancer Research UK chief executive Harpal Kumar added: "At a time when the finances of the health service are being squeezed, it is absolutely crucial that health commissioners plan now for a massive increase in demand for cancer services, to ensure we provide high quality care to all."

The charity's director of health information, Sara Hiom, said: "Smoking and drinking alcohol are two of the biggest things that increase the chance of developing oral, liver and kidney cancer - so by stopping smoking and cutting back on alcohol, we can lower our risk of these cancers as well as other diseases.

"Maintaining a healthy bodyweight is also important in cutting the risk of liver and kidney cancers."

A spokesman for England's Department of Health said the NHS was already responding to the challenge of an ageing population and increases in cancer cases.

"That is why we are investing more than £750m over the next four years to make sure people are diagnosed with cancer earlier and have better access to the latest treatments," he added.

Former teenage drinker Sam McDermott and Dr David Regis, author of the report, discuss the effects of drinking from a young age

A small number of children as young as 12 claimed they drank the equivalent of 19 glasses of wine a week when questioned for a health survey.

Research by the independent Schools Health Education Unit suggested that 4% of those questioned aged 12 or 13 claimed they drank 28 units or more.

However, the overall trend in the survey of almost 84,000 youngsters was for fewer to be drinking and smoking.

The government says it is cracking down on those who sell alcohol to children.

The data was collected from 1,100 primary and secondary schools across the UK, covering 83,724 youngsters between the ages of 10 and 15.

They were asked more than 100 health-related behaviour questions on what they do at home, at school, and with their friends.

Dr David Regis from SHUE said the poll painted a mixed picture of young people's attitudes to drink.

"When we're looking at the alcohol figures there's good and bad news in there at the same time," he told the BBC.

"We've got an increasing number of pupils who are saying as far as they're concerned, alcohol is not for them at all, so the number of teetotallers has been going up in recent years, but we've also seen those youngsters that do drink maybe more likely than ever to go over the top."

A Department of Health spokesman said its drug strategy included measures to prevent alcohol misuse by young people.

"Children under 15 shouldn't be drinking at all," he said.

"We are... doubling the maximum fine for under-age alcohol sales to £20,000 and extending the period of voluntary closure that can be given as an alternative to prosecution for persistent under-age selling from 48 hours to two weeks."

'Specialist support'

Data collected from pupils in years six, eight and 10 indicated that 11% of year 10 pupils - aged 14 to 15 - drank more than 10 units of alcohol in the week before the survey.

However, fewer children said they had been drunk in the preceding week than in previous surveys.

Three units equates to two small (125ml) glasses of wine (containing 12% of alcohol by volume) or a whole pint of strong lager (5% ABV) or cider, according to the advice charity Drinkaware.

Just 3% of those surveyed said they had spent two hours doing homework the previous day

"Children who drink at younger ages are the ones who need help most. We also know that children whose parents misuse alcohol are more likely to develop their own problems later in life," he said.

Just over half of those aged 14 or 15 said they had never tried cigarettes, while 95% of 10- and 11-year-olds said they had never smoked.

Cannabis was the most tried drug by year 10 pupils, with 15% of the boys saying they had taken it. However, a very small percentage had tried other drugs such as heroin, cocaine, ecstasy and crack.

One in 10 of the age group had mixed drugs and alcohol at the same time.

The results also raised concerns that some youngsters are not getting enough sleep, with almost half of year 10 girls admitting they did not get enough to stay alert at school. Some 41% of boys said the same.

Almost a quarter of boys in years eight and 10 spent more than two hours playing computer games the day before they were surveyed, while one in seven pupils in the same year groups said they had spent more than two hours watching TV.

Skipping breakfast

But only 3% said they spent this amount of time on homework, with 36% saying they spent no time at all on it, and 41% saying their homework took up to 30 minutes.

The report found more than a third of girls aged 10 to 11 would like to lose weight, with two-thirds of year 10 girls saying the same.

A third of the latter group had skipped breakfast that day, with 24% saying they had not eaten lunch on the previous day.

A third of girls aged 10 to 11, and 29% of those aged 12 to 13, said they were afraid of going to school because of bullying at least sometimes.

And while 6% of boys aged 14 to 15 said others may fear going to school because of bullies, 10% admitted they had bullied someone in the previous year.

The teenagers were also asked whether they ever carried weapons for protection. Of the Year 10 boys, 18% said they may carry a weapon, with 5% of these always carrying one.

By Nick Triggle Health correspondent, BBC News There are an estimated 27,000 extra deaths each winter Winter weather alerts aimed at helping vulnerable people during cold snaps are to be introduced in England.

Agencies such as the NHS and social services will get the Met Office alerts and will then have to take action to ensure people are safe in their homes.

An estimated 27,000 extra people die every winter - a fifth more than during the summer.

Extra cash is also being used to help people keep homes warm, but some question whether this will be enough.

Instead, they have called on the government to do more to tackle the underlying problem - the rising cost of energy.

England has a much higher death rate during winter than many colder countries, such as Sweden.

Schemes, such as Warm Front, have been running for a number of years to help pay for people to insulate their homes or make heating improvements.

'Not enough'

The Department of Health has pledged an extra £10m for this initiative - on top of the £110m. However, even with the extra money, the fund has still been cut compared to previous years.

A new fund, worth £20m, is also being set up to encourage councils and charities to come up with new ways of helping the most vulnerable.

The cold weather plan has been drawn up in partnership with the Met Office and Health Protection Agency.

Continue reading the main story Death rates rise by about a fifth during the winterThat is the equivalent of an extra 27,000 deaths on top of the normal number of deaths that would be expectedAbout 40% of these are from heart attacks and strokes, while another third are related to respiratory problemsIt is recommended that indoor temperatures of 21C are maintained during the day and 16C at nightBelow 16C the body's resistances to respiratory disease is diminished.Below 12C blood pressure starts to riseUnder the new arrangements, the Met will issue alerts depending on the severity of the conditions. In total, there will be four alerts, each of which will ask local agencies, including NHS trusts and councils, to carry out certain duties.

For example, at level three, which would have been reached last winter, health and social care staff should consider daily visits to the most vulnerable.

In previous years it has been up to local areas to decide how to react to cold snaps.

The plan also contains advice to individuals and carers, such as ensuring at-risk groups get vaccinated against flu and what temperature to keep homes heated to.

A minimum of 21C is being recommended during the day and 16C at night, as below that the risk of heart problems, strokes and respiratory illness increases.

Health Secretary Andrew Lansley said: "We want everyone to get ready for winter and be prepared before temperatures drop. By working together, this co-ordinated plan will help protect those most in need."

"We just need to keep the main rooms we occupy - such as the living room and bedroom - warm. Warm clothing and hot drinks should help prevent our most vulnerable people falling ill this winter."

But Mervyn Kohler, a special adviser for Age UK and member of the government's fuel poverty advisory group, said while it was pleasing the NHS was now recognising the problem, much more needed to be done.

"The extra resources being put in is not enough. We also have to do more to tackle the big problem everyone is facing, the rising cost of energy bills. We need action across government if this is to be achieved."

Ovarian cancer A "fatty apron" in the abdomen helps fuel the spread of ovarian cancer, research suggests.

In 80% of cases, it has spread to this apron, called the omentum, by the time it is diagnosed.

The Nature Medicine research found once ovarian cancer cells reach the omentum, they take it over.

UK experts said the study was important in aiding understanding of ovarian cancer, the fifth most common cancer in women in the UK.

The omentum lies in the upper abdomen near the stomach. It helps support the organs nearby, but it is not essential.

Often, cancer growth in the omentum exceeds the growth of the original ovarian tumour.

The University of Chicago team injected ovarian cancer cells into the abdomen of healthy mice. They reached the omentum within 20 minutes.

They found that protein signals emitted by the omentum attracted the tumour cells. Disturbing these signals reduced this attraction by at least 50%.

Once ovarian cancer cells reach the omentum, they were found to change so they could feed off the fat cells.

Feeding cancer spread

The researchers suggest that a protein known as fatty acid binding protein (FABP4), a fat carrier, could be key to the process and could be a target for treatment.

Tumour cells next to fat cells in the omentum were found to produce high levels of FABP4, while cancer cells far away from fat cells did not.

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The cells that make up the omentum contain the biological equivalent of jet fuel. ”

End Quote Prof Ernst Lengyel, Lead author When the action of FABP4 was blocked, the transfer of nutrients from fat cells to cancer cells was drastically reduced. It also reduced tumour growth and the ability of tumours to generate new blood vessels.

Lead author Ernst Lengyel, professor of obstetrics and gynaecology at the University of Chicago, said: "The cells that make up the omentum contain the biological equivalent of jet fuel.

"They feed the cancer cells, enabling them to multiply rapidly. Gaining a better understanding of this process could help us learn how to disrupt it."

The researchers suggest fat metabolism may also contribute to other cancers, such as breast, gastric and colon.

Dr Kat Arney, of Cancer Research UK, said: "These are important results because they suggest that fat cells in the stomach can fuel the spread of ovarian cancer, and point towards potential targets for the development of new treatments for the disease.

"But at the moment these are still early experiments using mice and cells grown in the lab, so there's still a lot of work to be done to turn this knowledge into a treatment that could help women with ovarian cancer."